The purpose of this study was to assess the safety and efficacy of percutaneous transluminal cerebral balloon angioplasty (PTCBA) of extra- and intra-cranial arteries by investigating procedural outcome. Eighty haemodynamically significant extra- and intra-cranial lesions (% diameter stenosis > 70) in 74 clinically symptomatic patients were treated by elective and initial PTCBA between March 1991 and February 1996 and thereafter followed. Death, stroke, surgery, or repeated angioplasty of restenosis or new lesions were regarded as cerebral events after the initial PTCBA. The procedural and clinical success rates were 81 % (65 of 80) and 81 % (60 of 74), respectively. Progressively ischaemic symptoms disappeared completely after clinically successful dilatation. Angiographic restenosis rate at 3 months was 22 %(14 of 65). By life-table method, the death/stroke risk was 16 %, and any cerebral event risk was 49 % at 2 years following PTCBA, respectively. The most common of first cerebral events presented was repeated angioplasty of restenosis. In conclusion, PTCBA has great efficacy in decreasing recurrent neurological symptoms and produces a favourable short-term outcome, whereas restenosis limits long-term benefit.